Nakamura H, Hirata F, Yasugi T, Mizuno M, Saito E, Ishikawa T, Tada N, Nakaya N, Homma Y, Takeuchi I
National Defense Medical College, Tokorozawa City, Japan.
Drugs. 1988;36 Suppl 1:25-34. doi: 10.2165/00003495-198800361-00006.
Several antihypertensive agents such as thiazide diuretics and some beta-blockers have recently been shown to adversely affect lipid metabolism. Moreover, there is a growing suspicion that the adverse effect on plasma lipids might outweigh the favourable effect of lowering blood pressure. The effect of ketanserin tartrate (20 to 60 mg daily), a new antihypertensive drug, on blood lipids was evaluated in a 12-week non-comparative clinical trial in 34 patients with mild or moderate hypertension. Ketanserin reduced systolic and diastolic blood pressure by 12.2 and 9.8%, respectively, without altering heart rates. Total cholesterol and low density lipoprotein (LDL)-cholesterol levels in the fasting plasma were observed to decrease significantly by 6.3 and 8.8% respectively, whereas mean triglyceride and high density lipoprotein (HDL)-cholesterol remained almost unchanged. These changes were consistent irrespective of their initial values. Significant decrease in apolipoprotein B and E was also observed. Apolipoprotein A-I, A-II, C-II and C-III were not altered significantly. It is speculated that ketanserin affects mainly LDL-cholesterol. Based on these findings, ketanserin is considered to have a potentially beneficial effect on coronary risk profile and should be given full consideration when drug therapy is selected for patients with mild to moderate hypertension.
几种抗高血压药物，如噻嗪类利尿剂和一些β受体阻滞剂，最近已被证明会对脂质代谢产生不利影响。此外，人们越来越怀疑对血浆脂质的不利影响可能超过降低血压的有利影响。在一项针对34例轻度或中度高血压患者的为期12周的非对照临床试验中，评估了新型抗高血压药物酒石酸酮色林（每日20至60毫克）对血脂的影响。酮色林分别使收缩压和舒张压降低了12.2%和9.8%，且心率未发生改变。空腹血浆中的总胆固醇和低密度脂蛋白（LDL）胆固醇水平分别显著降低了6.3%和8.8%，而平均甘油三酯和高密度脂蛋白（HDL）胆固醇几乎保持不变。无论其初始值如何，这些变化都是一致的。载脂蛋白B和E也显著降低。载脂蛋白A-I、A-II、C-II和C-III没有显著改变。据推测，酮色林主要影响LDL胆固醇。基于这些发现，酮色林被认为对冠状动脉风险状况具有潜在的有益作用，在为轻度至中度高血压患者选择药物治疗时应予以充分考虑。
